Long-term clinical and angiographic follow-up results of the dual-layer flow diverter device (FRED) for the treatment of intracranial aneurysms in a multicenter study

2021 ◽  
Author(s):  
Hasan Dinc ◽  
Isil Saatci ◽  
Sukru Oguz ◽  
Feyyaz Baltacioglu ◽  
Altan Yildiz ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Layer Flow ◽  
Flow Diverter Device

scholarly journals Flow-Diverter Silk Stent for the Treatment of Intracranial Aneurysms: 1-year Follow-Up in a Multicenter Study

2012 ◽  
Vol 33 (6) ◽  
pp. 1150-1155 ◽  
Author(s):  
J. Berge ◽  
A. Biondi ◽  
P. Machi ◽  
H. Brunel ◽  
L. Pierot ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Silk Stent

scholarly journals Long-term occlusion results with SILK flow diversion in 28 aneurysms: Do recanalizations occur during follow-up?

2015 ◽  
Vol 21 (3) ◽  
pp. 300-310 ◽  
Author(s):  
Anastasios Mpotsaris ◽  
Martin Skalej ◽  
Oliver Beuing ◽  
Bernd Eckert ◽  
Daniel Behme ◽  
...  
Keyword(s):  
Prospective Study ◽  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Success Rates ◽  
Imaging Data ◽  
Complete Occlusion ◽  
Complex Aneurysms ◽  
Multicenter Prospective Study

Background and purpose The purpose of this article is to report on the long-term success rates of Silk flow-diverter (FD) treatment in a multicenter prospective study for the treatment of complex aneurysms. Methods Between May 2008 and January 2011, all consecutive patients featuring complex intracranial aneurysms eligible for FD treatment with the Silk in three neurovascular centers were included. Clinical and imaging data were assessed during hospitalization and follow-up. Results Five patients were initially asymptomatic, 20 patients showed various neurological symptoms. Twenty-eight FDs were implanted in 25 patients treating 28 aneurysms. The immediate procedure-related morbidity was 8% (two of 25), mortality 0%. One procedure-related death was observed during follow-up (in-stent thrombosis). Compared to the immediate result nearly two of three aneurysms improved during follow-up; all angiographically confirmed inflow changes took place within six months after treatment. Final anatomic outcome in 24 aneurysms of 22 patients comprised 14 (59%) with complete occlusion, seven (29%) with a neck remnant, two (8%) with residual filling <50%, none with residual filling >50% and one (4%) unchanged in comparison to its pretreatment status. Postinterventional recanalizations were seen in three of 13 (23%) aneurysms treated with FD alone; none were observed in 15 aneurysms treated with adjunctive coiling. Conclusion Anatomic presentation and location are key for successful FD treatment. The rate of successful occlusion increases during follow-up. Postinterventional monitoring for at least six months is paramount, as anatomic outcome is not reliably predictable and recanalizations may occur in initially completely occluded aneurysms.

scholarly journals Timing and Spectrum of Neurological Complications After Flow Diverter Implantation for Intracranial Aneurysms

2021 ◽  
Vol 12 ◽  
Author(s):  
Guillaume Charbonnier ◽  
Jean-Philippe Desilles ◽  
Simon Escalard ◽  
Benjamin Maier ◽  
Gabriele Ciccio ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Neurological Complication ◽  
Neurological Complications ◽  
Flow Diverter ◽  
Factors Associated ◽  
Long Term Follow Up ◽  
Ischemic Complications ◽  
Ischemic Events

Background and Purpose: The aim of this study was to characterize neurological complications after flow diverter (FD) treatment on a long follow-up cohort and identify predictive factors associated with these complications.Methods: This study was conducted on a monocentric cohort of patients treated for intracranial aneurysms by FD.Results: Between September 2008 and July 2018, 413 patients were treated for 514 aneurysms: 18% of the patients presented with at least one neurological complication during a median follow-up of 446 days (IQR 186–1,210). Sixty-one patients presented with ischemic complications, 13 with hemorrhagic ones and 10 with compressive processes. Among 89 neurological complications 64.5% were peri-operative (occurring within the 30 days following the procedure) and 35.5% were delayed after 1 month.Conclusions: Overall, neurological complications after FD implantation were overrepresented by cerebrovascular ischemic events occurring during the peri-operative period, but also in a delayed manner after 1 year. Long-term follow-up is relevant after aneurysm intervention using FD.

Long-term follow-up in the endovascular treatment of intracranial aneurysms with flow-diverter stents: update of a single-centre experience

2018 ◽  
Vol 123 (6) ◽  
pp. 449-455 ◽  
Author(s):  
Giuseppe Guzzardi ◽  
Carmelo Stanca ◽  
Paolo Cerini ◽  
Bruno Del Sette ◽  
Ignazio Divenuto ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Single Centre ◽  
Single Centre Experience ◽  
Long Term Follow Up

Abstract WP85: Flow-diverter Embolization for Tandem Intracranial Aneurysms: A Single Center Experience

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Andrew Bauer ◽  
Mark Bain ◽  
Thomas Masaryk ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Single Center ◽  
Anterior Circulation ◽  
Single Center Experience ◽  
Flow Diverter Stent ◽  
Artery Segment ◽  
Treat All

Introduction: Flow diverter embolization is a novel method to treat intracranial aneurysms. The device has been shown to reduce procedure time and radiation exposure along with excellent long-term occlusion rates for single lesions. However, the effect of flow diversion on multiple adjacent aneurysms has not been well studied. We present our single center experience with flow diverter treatment of tandem aneurysms. Methods: We retrospectively collected clinical, imaging, procedural and follow up data on patients in whom flow diverters were used to treat intracranial anterior circulation aneurysms between 2011 and 2016. We included patients who had 2 or more tandem aneurysms of the internal carotid artery segment and where flow diverter was intended to treat all the aneurysms either as primary or secondary method. Results: We identified 21 patients with 52 aneurysms that met inclusion criteria. All were females with median age of 57 (Interquartile range [IQR] 51 - 69). Seventeen patients had 2 adjacent aneurysms, while 4 patients had 3 contiguous aneurysms. Of these, only one patient was treated acutely for ruptured aneurysm. The median largest aneurysm diameter was 3.1mm (IQR 2.5 - 4.8) with most common locations being cavernous and ophthalmic aneurysms. In 19 patients (90.5%) only a single flow diverter stent was used; only one patient required concurrent coiling. One patient (4.8%) suffered a post procedural mild stroke but improved rapidly. There were no other procedural complications. Follow up data in 13 patients (61.9%) with a median follow up of 8 months (IQR 6 - 13) demonstrated that 20 out of 28 aneurysms showed complete occlusion (71.4%). None of the patients at follow up required re-treatment, and there were no delayed/late aneurysm ruptures. Conclusion: Flow diverter is a feasible, efficacious and safe treatment option in patients with multiple tandem aneurysms, in a single session with good early outcomes. Long term follow up data and large cohort studies are required.

Midterm and long-term follow-up of cerebral aneurysms treated with flow diverter devices: a single-center experience

2013 ◽  
Vol 118 (2) ◽  
pp. 408-416 ◽  
Author(s):  
Mariangela Piano ◽  
Luca Valvassori ◽  
Luca Quilici ◽  
Guglielmo Pero ◽  
Edoardo Boccardi
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Long Term Results ◽  
Maximum Diameter ◽  
Consecutive Series ◽  
Flow Diverter Devices

Object The introduction of flow diverter devices is revolutionizing the endovascular approach to cerebral aneurysms. Midterm and long-term results of angiographic, cross-sectional imaging and clinical follow-up are still lacking. The authors report their experience with endovascular treatment of intracranial aneurysms using both the Pipeline embolization device and Silk stents. Methods From October 2008 to July 2011 a consecutive series of 104 intracranial aneurysms in 101 patients (79 female, 22 male; average age 53 years) were treated. Three of the 104 aneurysms were ruptured and 101 were unruptured. Silk stents were implanted in 47 of the aneurysms and Pipeline stents in the remaining 57. In 14 cases a combination of flow diverter devices and coils were used to treat larger aneurysms (maximum diameter > 15 mm). Patients underwent angiographic follow-up examination at 6 months after treatment, with or without CT or MRI, and at 1 year using CT or MRI, with or without conventional angiography. Results In all cases placement of flow diverter stents was technically successful. The mortality and morbidity rates were both 3%. Adverse events without lasting clinical sequelae occurred in 20% of cases. Angiography performed at 6 months after treatment showed complete aneurysm occlusion in 78 of 91 cases (86% of evaluated aneurysms) and subocclusion in 11 (12%); only in 2 cases were the aneurysms unchanged. Fifty-three aneurysms were evaluated at 1 year after treatment. None of these aneurysms showed recanalization, and 1 aneurysm, which was incompletely occluded at the 6-month follow-up examination, was finally occluded. Aneurysmal sac shrinkage was observed in 61% of assessable aneurysms. Conclusions Parent artery reconstruction using flow diverter devices is a feasible, safe, and successful technique for the treatment of endovascular treatment of cerebral aneurysms.

scholarly journals Flow diverter stents in the treatment of recanalized intracranial aneurysms

2021 ◽  
pp. 159101992199050
Author(s):  
Erol Akgul ◽  
Hasan Bilen Onan ◽  
Irem Islek ◽  
Mehmet Tonge ◽  
Yavuz Durmus ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Demographic Data ◽  
Previous Treatment ◽  
Flow Diverter ◽  
Serious Adverse Events ◽  
Clinical Complications ◽  
Tertiary Hospitals ◽  
The Mean ◽  
Technical Complication

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.

scholarly journals Endovascular Treatment of Anterior Circulation Aneurysms With the p64 Flow Modulation Device: Mid- and Long-Term Results in 617 Aneurysms From a Single Center

2021 ◽  
Author(s):  
Marta Aguilar Pérez ◽  
Elina Henkes ◽  
Victoria Hellstern ◽  
Carmen Serna Candel ◽  
Christina Wendl ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
High Rate ◽  
Long Term Results ◽  
Effective Treatment Option ◽  
Anterior Circulation ◽  
Acute Hemorrhage ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.

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